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TennCare-Paid Claim Losses Climb At Erlanger by Judy Frank posted October 23, 2006 It cost Erlanger Health System about $5.3 million to treat TennCare patients during September, but the medical center was reimbursed for just $2.3 million of that total, according to figures released Monday during a meeting of the finance committee of the hospital authority. The result: Erlanger lost more than $3 million on TennCare claims during that single month. Since July 1, the start of the current fiscal year, Erlanger has lost $5.1 million in TennCare-paid claims. That’s because it cost the medical center more than $10.1 million to treat TennCare patients, but was reimbursed just Britt Tabor, Erlanger’s chief financial officer, told finance committee members that another $11.7 million in uncompensated care costs since July 1 can be tracked to charity, bad debt, out-of-state Medicaid and outstanding TennCare costs. Often, a single case results in many thousands of dollars in claim losses, committee members learned. For example, Erlanger’s cost to provide a craniotomy for multiple significant trauma was more than $100,000, according to figures that Tabor released, but TennCare paid the medical center just $22,000. Treating a newborn with extreme immaturity or respiratory distress syndrome cost Erlanger more than $50,000, but TennCare reimbursed the medical center just $24,000. And a premature birth without major problems cost the medical center more than $27,000 – 10 times the $2,700 which TennCare paid. |
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